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Upright exercise or supine lower body negative pressure exercise maintains exercise responses after bed rest

Adaptation to bed rest or space flight is accompanied by an impaired ability to exercise in an upright position. We hypothesized that a daily, 30-min bout of intense, interval exercise in upright posture or supine against lower body negative pressure (LBNP) would maintain upright exercise heart rate and respiratory responses after bed rest. Twenty-four men (31 +/- 3 yr) underwent 5 d of 6 degree head-down tilt: eight performed no exercise (CON), eight performed upright treadmill exercise (UPex), and eight performed supine treadmill exercise against LBNP at -51.3 +/- 0.4 mm Hg (LBNPex). Submaximal treadmill exercise responses (56, 74, and 85% of VO2peak) were measured pre- and post-bed rest. In CON, submaximal heart rate, respiratory exchange ratio, and ventilation were significantly greater (P < or = 0.05) after bed rest. In UPex and LBNPex, submaximal exercise responses were similar pre- and post-bed rest. Our results indicate that a daily 30-min bout of intense, interval upright exercise training or supine exercise training against LBNP is sufficient to maintain upright exercise responses after 5 d of bed rest. These results may have important implications for the development of exercise countermeasures during space flight.

NASA Center ARC↗

Variability of prediction of maximal oxygen concumption on the cycle ergometer using standard equations

Several investigations within the Exercise Countermeasures Project at the NASA Johnson Space Center focused on the assessment of maximum oxygen consumption (VO2(sub max)) within the Astronaut Corps pre- and postspace flight. Investigations during the Apollo era suggested that there was a significant decrease in postflight VO2(sub max) when compared to preflight values, and current studies have documented that this trend continues in the Space Shuttle era. It is generally accepted and was confirmed in our laboratory that VO2(sub max) can be predicted from submaximal measures taken during graded exercise tests on the cycle ergometer with respect to populations. However, previous work had not examined the effect of day-to-day variations in the physiologic responses that might alter these predictions for individuals. Stability of individual submaximal data over serial tests is important so that predicted changes in VO2(sub max) are reflective of actual VO2(sub max) changes. Therefore, the purpose of this investigation was to determine which of the accepted equations to predict VO2(sub max) would be less affected by normal daily physiologic changes.

Greenisen, Michael C.↗

Human Stability While Exercising on a VIS Device in Zero Gravity

BACKGROUND: A Vibration Isolation and Stabilization (VIS) system is being designed for use with the European Enhanced Exploration Exercise Device (E4D) [1]. The exercise bar is attached to cables that extend and retract through openings in the E4D platform, which the subject stands on while exercising. Since the E4D is mounted on a moving VIS device, the whole system moves under the subject’s feet. While tension in the cables does help stabilize a crew member in 0g by bracing him or her against the moving platform, flexible cables do not offer full support against falling. This raises the question of whether various exercises that are successfully performed in 1g on a stationary device can be performed without losing balance in 0g on a moving device. Quantifying stability conditions and establishing stability requirements for exercise countermeasure systems is a long-standing challenge and this work helped to inform this specific need for integrated E4D/VIS flight project development. METHODS AND RESULTS: A simplified stability analysis can be attempted based on platform accelerations generated by the VIS device simulation. In this type of analysis, the subject is conceived as standing on the platform in 0g while being held down to it by the tension in the cables. If the sideways acceleration of the platform is such that the cables cannot generate a sufficient moment relative to, e.g., the heels or the toes of the subject to overcome the tipping moment from the inertial forces on the accelerated subject’s body, the subject becomes unstable. This approach, which we refer to as the ‘static’ approximation, indicated failure of all the exercises that were considered in the comprehensive VIS analysis of the E4D. It was realized, however, that platform accelerations are not externally imposed but are themselves induced by the motion of the subject’s body during exercise, and a model calculation confirmed that this drastically altered the tipping moment on the subject, with the potential to even switch the direction in which the body would tip over. This made it imperative to consider in a coupled manner both the motion of the exercising subject’s body and the induced VIS platform motion while considering stability. The coupled dynamics requirement was met by the VIS simulation incorporating time-dependent human mass properties atop the platform and driven by the inertial forces from the prescribed subject motion relative to the platform based on motion-capture recorded human trajectories in 1g on a stationary E4D [2]. To analyze simulation results, a stability criterion was also needed. We do not know how to account for the human ‘control system’ that would take visual and vestibular cues as inputs as the platform moves in 0g. We thus chose to follow an approach we had previously used to analyze the dynamic feasibility of performing a task in lunar gravity along the human body trajectory recorded in 1g [3]. In this approach, one analyzes the center of pressure (COP) between the shoes and the ground (or platform) and checks if the COP remains within the convex hull of the footprints on the ground (or platform), commonly referred to as base of support (BOS). Since pressure is vertical and, in the absence of foot restraints, positive, the COP going outside the BOS indicates that the trajectory recorded in 1g is not dynamically feasible in microgravity and/or on the moving platform of the device. The outcome of the COP-based analysis was that some of the key exercises, especially the deadlift and the back squat exercises, were found to be dynamically feasible for at least some number of the exercise cycles, this number increasing with the cable tension. While this type of stability analysis does not account for the likely alteration of the exercise trajectory from its 1g form in space, it does show that there exist at least some realistic trajectories that pass the dynamic feasibility criterion. This adds confidence that, with further adjustment by the subject of the exercise form in 0g on a moving device, a number of exercises can be performed without losing balance.

D Frenkel↗

Noninvasive Sensor for Measuring Muscle Metabolism During Exercise

The measurement of oxygen uptake (VO2) and lactate threshold (LT) are utilized to assess changes in aerobic capacity and the efficacy of exercise countermeasures in astronauts. During extravehicular activity (EVA), real-time knowledge of VO2 and relative work intensity can be used to monitor crew activity levels and organize tasks to reduce the cumulative effects of fatigue. Currently VO2 and LT are determined with complicated measurement techniques that require sampling of expired ventilatory gases, which may not be accurate in enclosed, oxygen-rich environments such as the EVA suit. The UMMS team has developed a novel near infrared spectroscopic (NIRS) system which noninvasively, simultaneously and continuously measures muscle oxygen tension, oxygen saturation, pH (pHm), and hematocrit from a small sensor placed on the leg. This system is unique in that it allows accurate, absolute measurement of these parameters in the thigh muscle by correcting spectra for the interference from skin pigment and fat. These parameters can be used to estimate VO2 and LT. A preliminary evaluation of the system s capabilities was performed in the NASA JSC Exercise Physiology Lab.

Soller, B. R.↗

Human Research Program Human Health Countermeasures Element Extravehicular Activity (EVA) Risk Standing Review Panel (SRP)

The Extravehicular Activity (EVA) Risk Standing Review Panel (SRP) was favorably impressed by the operational risk management approach taken by the Human Research Program (HRP) Integrated Research Plan (IRP) to address the stated life sciences issues. The life sciences community at the Johnson Space Center (JSC) seems to be focused on operational risk management. This approach is more likely to provide risk managers with the information they need at the time they need it. Concerning the information provided to the SRP by the EVA Physiology, Systems, and Performance Project (EPSP), it is obvious that a great deal of productive activity is under way. Evaluation of this information was hampered by the fact that it often was not organized in a fashion that reflects the "Gaps and Tasks" approach of the overall Human Health Countermeasures (HHC) effort, and that a substantial proportion of the briefing concerned subjects that, while interesting, are not part of the HHC Element (e.g., the pressurized rover presentation). Additionally, no information was provided on several of the tasks or how they related to work underway or already accomplished. This situation left the SRP having to guess at the efforts and relationship to other elements, and made it hard to easily map the EVA Project efforts currently underway, and the data collected thus far, to the gaps and tasks in the IRP. It seems that integration of the EPSP project into the HHC Element could be improved. Along these lines, we were concerned that our SRP was split off from the other participating SRPs at an early stage in the overall agenda for the meeting. In reality, the concerns of EPSP and other projects share much common ground. For example, the commonality of the concerns of the EVA and exercise physiology groups is obvious, both in terms of what reduced exercise capacity can do to EVA capability, and how the exercise performed during an EVA could contribute to an overall exercise countermeasure prescription.

Norfleet, William↗

Exercise and pharmacological countermeasures for bone loss during long-duration space flight

Bone loss in the lower extremities and lumbar spine is an established consequence of long-duration human space flight. Astronauts typically lose as much bone mass in the proximal femur in 1 month as postmenopausal women on Earth lose in 1 year. Pharmacological interventions have not been routinely used in space, and countermeasure programs have depended solely upon exercise. However, it is clear that the osteogenic stimulus from exercise has been inadequate to maintain bone mass, due to insufficient load or duration. Attention has therefore been focused on several pharmacological interventions that have been successful in preventing or attenuating osteoporosis on Earth. Anti-resorptives are the class of drugs most commonly used to treat osteoporosis in postmenopausal women, notably alendronate sodium, risedronate sodium, zoledronic acid, and selective estrogen receptor modulators, such as raloxifene. There has also been considerable recent interest in anabolic agents such as parathyroid hormone (PTH) and teriparatide (rhPTH [1-34]). Vitamin D and calcium supplementation have also been used. Recent studies of kindreds with abnormally high bone mineral density have provided insight into the genetic regulation of bone mass. This has led to potential therapeutic interventions based on the LRP5, Wnt and BMP2 pathways. Another target is the RANK-L/osteoprotegerin signaling pathway, which influences bone turnover by regulating osteoclast formation and maturation. Trials using such therapies in space are being planned. Among the factors to be considered are dose-response relationships, bone quality, post-use recovery, and combination therapies--all of which may have unique characteristics when the drugs are used in space.

NASA Discipline Musculoskeletal↗

Space Station Freedom (SSF) crew systems SE&I

Space Station program office planning and requirements activity has accelerated during the past year to bring the Space Station Freedom Program (SSF) through the program requirements review phase during 1988. The preliminary design review cycle began in Jan. 89, and is now planned for completion, with formal preliminary design reviews between Apr. and Sept., 1990. This paper briefly describes the PROGRAMMATIC aspects of the engineering and integration management of the SSF crew systems. Emphasis is given to the Crew Health Care System, which includes the Health Maintenance Facility, the Exercise Countermeasure Facility, and the Environmental Health System; all managed within the Man-Systems, one of the twelve 'distributed systems.' Medical and engineering requirements to meet the needs of the mature Space Station operations environment and highlights of critical technologies and equipment in development will be reviewed.

Austin, Frank H., Jr.↗

The role of pyridoxine as a countermeasure for in-flight loss of lean body mass

Ground based and in flight research has shown that humans, under conditions of microgravity, sustain a loss of lean body tissue (protein) and changes in several biological processes including, reductions in red blood cell mass, and neurotransmitters. The maintenance of muscle mass, the major component of lean body mass, is required to meet the needs of space station EVAs. Central to the biosynthesis of amino acids, the building blocks of protein, is pyridoxine (vitamin B-6). Muscle mass integrity requires the availability of vitamin B-6 for protein metabolism and neurotransmitter synthesis. Furthermore, the formation of red blood cells require pyridoxine as a cofactor in the biosynthesis of hemoglobin, a protein that carries oxygen to tissues. In its active form, pyridoxal-5'-phosphate (PLP), vitamin B-6 serves as a link between amino acid and carbohydrate metabolism through intermediates of glycolysis and the tricarboxylic acid cycle. In addition to its role in energy metabolism, PLP is involved in the biosynthesis of hemoglobin and neurotransmitter which are necessary for neurological functions. Alterations in pyridoxine metabolism may affect countermeasures designed to overcome some of these biochemical changes. The focus of this research is to determine the effects of microgravity on the metabolic utilization of vitamin B-6, integrating nutrition as an integral component of the countermeasure (exercise) to maintain lean body mass and muscle strength. The objectives are: 1) to determine whether microgravity effects the metabolic utilization of pyridoxine and 2) to quantitate changes in B-6 vitamer distribution in tissue and excreta relative to loss of lean body tissue. The rationale for this study encompasses the unique challenge to control biochemical mechanisms effected during space travel and the significance of pyridoxine to maintain and counter muscle integrity for EVA activities. This experiment will begin to elucidate the importance of biochemical interactions between micronutrients and the homeostasis condition of biological processes in the space environment. To address this research topic a simulated microgravity model has been developed. The experiment uses radioisotopically labelled pyridoxine administered as an oral dose to rats which are maintained by tail suspension to simulate a microgravity environment. At the termination of the study, liver, muscle, blood and urine are collected and analyzed by reverse phase high pressure liquid chromatography to determine the quantity and distribution of the B-6 vitamers in tissue and excreta relative to lean body tissue loss. Earlier studies, published by this investigator, have shown that differences in vitamer distribution among samples from experimental versus control subjects indicate changes in metabolic utilization and storage of vitamin B-6.

Gilbert, Joyce A.↗

Workshop on Countering Space Adaptation with Exercise: Current Issues

The proceedings represent an update to the problems associated with living and working in space and the possible impact exercise would have on helping reduce risk. The meeting provided a forum for discussions and debates on contemporary issues in exercise science and medicine as they relate to manned space flight with outside investigators. This meeting also afforded an opportunity to introduce the current status of the Exercise Countermeasures Project (ECP) science investigations and inflight hardware and software development. In addition, techniques for physiological monitoring and the development of various microgravity countermeasures were discussed.

Harris, Bernard A.↗

Predicting Bone Mechanical Properties of Cancellous Bone from DXA, MRI, and Fractal Dimensional Measurements

This project was aimed at making predictions of bone mechanical properties from non-invasive DXA and MRI measurements. Given the bone mechanical properties, stress calculations can be made to compare normal bone stresses to the stresses developed in exercise countermeasures against bone loss during space flight. These calculations in turn will be used to assess whether mechanical factors can explain bone loss in space. In this study we assessed the use of T2(sup *) MRI imaging, DXA, and fractal dimensional analysis to predict strength and stiffness in cancellous bone.

Harrigan, Timothy P.↗

Procedures of Exercise Physiology Laboratories

This manual describes the laboratory methods used to collect flight crew physiological performance data at the Johnson Space Center. The Exercise Countermeasures Project Laboratory is a standard physiology laboratory; only the application to the study of human physiological adaptations to spaceflight is unique. In the absence of any other recently published laboratory manual, this manual should be a useful document staffs and students of other laboratories.

Bishop, Phillip A.↗

Evaluation of Thermoregulation After Spaceflight

Altered thermoregulation has been reported following spaceflight simulations such as water immersion and bedrest but it has never been evaluated immediately after actual spaceflight. Impaired thermoregulation may have significant impact during various spaceflight activities such as countermeasure exercise, extravehicular activity (EVA), landing, and egress. It would be manifested as an increased body temperature and heart rate and decreased work capacity and endurance. In this study we evaluated the exercise responses of two crewmembers following a long duration spaceflight and measured their changes in body temperatures, skin blood flow, sweating and heat production during a mild submaximal exercise stress.

Schneider, S. M.↗

Space Flight Effects on Intracellular Ions in Sublingual Cells of Non-Human Primates

We have used a novel technique that quantifies minerals and electrolytes from smears of sublingual cells by x-ray microanalysis to monitor metabolic changes in bed rest subjects. Increases in intracellular calcium (Ca), phosphorus (P), and potassium (K) were characteristic of subjects whose exercise regimen was inadequate to maintain calcium metabolism. To test the effects of space flight on intracellular ions, we analyzed cells from 2-4 kg Rhesus monkeys before and after 2 weeks in space or chair restraint (CR). There were increases in sublingual cell Ca, P and K after space flight which paralleled the clinical estimates of metabolic status of the animals and exceeded the levels found during CR on R+11. Increases after 2 weeks CR were 26% in Ca, 6% in P and 29% in K. Species similarity ill responses of intracellular ions to inactivity imposed by bed rest, restraint or microgravity suggest that this innovative non-invasive technique would be a useful in-flight monitor of exercise countermeasures directed toward maintaining calcium balance.

Arnaud, Sara B.↗

Physiology of a microgravity environment invited review: microgravity and skeletal muscle

Spaceflight (SF) has been shown to cause skeletal muscle atrophy; a loss in force and power; and, in the first few weeks, a preferential atrophy of extensors over flexors. The atrophy primarily results from a reduced protein synthesis that is likely triggered by the removal of the antigravity load. Contractile proteins are lost out of proportion to other cellular proteins, and the actin thin filament is lost disproportionately to the myosin thick filament. The decline in contractile protein explains the decrease in force per cross-sectional area, whereas the thin-filament loss may explain the observed postflight increase in the maximal velocity of shortening in the type I and IIa fiber types. Importantly, the microgravity-induced decline in peak power is partially offset by the increased fiber velocity. Muscle velocity is further increased by the microgravity-induced expression of fast-type myosin isozymes in slow fibers (hybrid I/II fibers) and by the increased expression of fast type II fiber types. SF increases the susceptibility of skeletal muscle to damage, with the actual damage elicited during postflight reloading. Evidence in rats indicates that SF increases fatigability and reduces the capacity for fat oxidation in skeletal muscles. Future studies will be required to establish the cellular and molecular mechanisms of the SF-induced muscle atrophy and functional loss and to develop effective exercise countermeasures.

short duration↗

Effect of a 17 day spaceflight on contractile properties of human soleus muscle fibres

1. Soleus biopsies were obtained from four male astronauts 45 days before and within 2 h after a 17 day spaceflight. 2. For all astronauts, single chemically skinned post-flight fibres expressing only type I myosin heavy chain (MHC) developed less average peak Ca2+ activated force (Po) during fixed-end contractions (0.78 +/- 0. 02 vs. 0.99 +/- 0.03 mN) and shortened at a greater mean velocity during unloaded contractions (Vo) (0.83 +/- 0.02 vs. 0.64 +/- 0.02 fibre lengths s-1) than pre-flight type I fibres. 3. The flight-induced decline in absolute Po was attributed to reductions in fibre diameter and/or Po per fibre cross-sectional area. Fibres from the astronaut who experienced the greatest relative loss of peak force also displayed a reduction in Ca2+ sensitivity. 4. The elevated Vo of the post-flight slow type I fibres could not be explained by alterations in myosin heavy or light chain composition. One alternative possibility is that the elevated Vo resulted from an increased myofilament lattice spacing. This hypothesis was supported by electron micrographic analysis demonstrating a reduction in thin filament density post-flight. 5. Post-flight fibres shortened at 30 % higher velocities than pre-flight fibres at external loads associated with peak power output. This increase in shortening velocity either reduced (2 astronauts) or prevented (2 astronauts) a post-flight loss in fibre absolute peak power (microN (fibre length) s-1). 6. The changes in soleus fibre diameter and function following spaceflight were similar to those observed after 17 days of bed rest. Although in-flight exercise countermeasures probably reduced the effects of microgravity, the results support the idea that ground-based bed rest can serve as a model of human spaceflight. 7. In conclusion, 17 days of spaceflight decreased force and increased shortening velocity of single Ca2+-activated muscle cells expressing type I MHC. The increase in shortening velocity greatly reduced the impact that impaired force production had on absolute peak power.

Clinical Trial↗

Kinematic Differences Between Motorized and Nonmotorized Treadmill Locomotion

There are few scientific publications comparing human locomotion between motorized and nonmotorized treadmills. Lakomy (1987) and Gamble et al (1988) reported that forward lean is greater on a nonmotorized treadmill to aid in the generation of horizontal force necessary for belt propulsion, but there are no data concerning lower limb kinematics. During long-term spaceflight, astronauts use locomotive exercise to mitigate the physiological effects caused by long-term exposure to microgravity. A critical decision for mission planners concerns the requirements for a treadmill to be used during potential trips to the Moon and Mars. Treadmill operation in an un-powered configuration could reduce mission resource demands, but also may impact the efficacy of treadmill exercise countermeasures. To ascertain the most appropriate type of treadmill to be used, it is important to understand biomechanical differences between motorized (M) and nonmotorized (NM) locomotion. The purpose of this evaluation was to test for differences in lower limb kinematics that occur during M and NM treadmill locomotion at two speeds. It was hypothesized that hip and knee joint angle trajectories would differ between the conditions.

DeWitt, John K.↗

Supine Lower Body Negative Pressure Exercise Maintains Upright Exercise Capacity in Male Twins during 30 Days of Bed Rest

Exercise capacity is reduced following both short and long duration exposures to microgravity. We have shown previously that supine lower body negative pressure with exercise (LBNP(sub ex) maintains upright exercise capacity in men after 5d and 15d bed rest, as a simulation of microgravity. We hypothesized that LBNP(sub ex) would protect upright exercise capacity (VO2pk) and sprint performance in eight sets of identical male twins during a 30-d bed rest. Twins within each set were randomly assigned to either a control group (CON) who performed no exercise or to an exercise group (EX) who performed a 40-min interval (40-80% pre-BR VO2pk) LBNP(sub ex) (55+/-4 mmHg) exercise protocol, plus 5 min of resting LBNP, 6 d/wk. LBNP produced footward force equivalent to 1.0- 1.2 times body weight. Pre- and post-bed rest, subjects completed an upright graded exercise test to volitional fatigue and sprint test of 30.5 m. After bed rest, VO2pk was maintained in the EX subjects (-3+/-3%), but was significantly decreased in the CON subjects (-24+/-4%). Sprint time also was increased in the CON subjects (24+/-8%), but maintained in the EX group (8+/-2%). The performance of a supine, interval exercise protocol with LBNP maintains upright exercise capacity and sprint performance during 30 d of bed rest. This exercise countermeasure protocol may help prevent microgravity-induced deconditioning during long duration space flight.

Lee, Stuart M. C.↗

Foot Reaction Forces during Long Duration Space Flight

Musculoskeletal changes, particularly in the lower extremities, are an established consequence of long-duration space flight despite exercise countermeasures. It is widely believed that disuse and reduction in load bearing are key to these physiological changes, but no quantitative data characterizing the on-orbit movement environments currently exist. Here we present data from the Foot Experiment (E318) regarding astronaut activity on the ground and on-orbit during typical days from 4 International Space Station (ISS) crew members who flew during increments 6, 8, 11, and 12.

Gopalakrishnan, R.↗